? Is Lily bouncing after going too low?

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Chalky

Chalky

Member Since 2021
Hi - new to the forum but been trying to get stable numbers for nearly a year now, so finally decided to try reaching out rather than just reading the messages. Lily seems to have a habit of sudden drops in BG level followed by a higher bounce back. Read an article saying that low BG can drive the liver(??) to produce glucose resulting in higher BG for a few days - which leads to higher dose - which makes matters worse.
Started off at 0.5 units and increased to 2 over several months but never managed to get stable results. Started home monitoring a couple of months ago and have uploaded the last months data to the spreadsheet. Have reduced the does down to 1.25 but still seeing highs followed by sudden drop and rebound. Should we be dropping the dose?
 
I don't see any PM cycle tests on your spreadsheet. Lily may be bouncing from the 122.
It would be best if you could get some night time tests, as cats will often go lower at night.
 
I was unsure if I should delay the shot after the low reading and continue testing or give a reduced shot. Further reading today suggests I should probably have delayed and continued testing until in the yellow (blue being too low for safety pre-jab on an unstable cat) - but still not clear how long you can delay before simply skipping the shot. If I delay for an hour it means the next shot will be an hour early.
 
A one hour delay is about all you want to do with Prozinc.

After that, it’s better to do a reduced dose or skip the shot. If your cat has ketones or has had DKA, then you don’t want to skip the insulin.
 
OK 1 hour makes sense otherwise the next shot is effectively early. Thanks.
I've never tested for ketones - I guess the vet has though on the two occasions Lily has been in after Hypo's and hasn't mentioned them as an issue. She is an outdoor cat and doesn't use a litter box so would have to keep her in separated from her brother to get a sample. However, she is on wet diabetic food x2 times daily (changed from a dry diabetic food on the 10th) and has never missed the chance to wolf the full amount down and her weight is stable at 4kg. So already doing the things advised here for a cat with keytones - but will look into getting testing kit if its considered beneficial.
I was also testing immediately after feeding, before shooting, and see it's advised to test before so have changed today. The change to wet food was because it seems to be generally accepted here that wet is better than dry - and that lower doses are generally needed - maybe I haven't dropped the dose enough.
My main question is if the cycle of a few days very high followed by a drop over a day to very low and then back to very high suggests I should be thinking of reducing the dose - maybe after the first sign of a reduction into the pinks pre-shot? Or do the high levels suggest an increase in dose?

Thanks for all your help.
 
You can get a blood ketone meter and test for ketones that way (vs testing urine). The downside is that the strips for a ketone meter are expensive. You don't have to test a lot, but it's a head's up as to cost.

It's hard to offer you lots of help given the limited information on Lily's spreadsheet. In most cases, dosing isn't based on the pre-shot numbers. Those numbers are helpful so you know that it's safe to shoot. However, you don't know how low Lily's numbers are going during the cycle. For example, you caught the 43 on 5/12 but it's entirely possible that Lily's numbers were even lower since that 43 is past when a nadir on Prozinc typically occurs. We encourage caregivers to get at least 4 tests per day -- your 2 pre-shot tests and at least one test closer to nadir during the AM and PM cycles, or a "before bed" test every PM cycle. It should give you a clearer sense of Lily's patterns.
 
Chalky said:
My main question is if the cycle of a few days very high followed by a drop over a day to very low and then back to very high suggests I should be thinking of reducing the dose - maybe after the first sign of a reduction into the pinks pre-shot? Or do the high levels suggest an increase in dose?
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Neither.

You don’t change the dose based on the preshots, but on the nadir or lows during he 12 hour cycle. So those mid-cycle tests become even more important. Please look at the dosing protocols in the Prozinc ISG, the Sticky posts at the top of that forum.

Most cats have a nadir around +5 to +7 when on Prozinc, but ECID and you need to test and see when YOUR cat has their nadir. That low doesn’t always occur at the same time every cycle either.
 
Hi - thanks - yes I was aware that the dose change is based on the nadir, but I didn't expect to see a low from such high numbers on a normal cycle so was waiting for the numbers to drop towards the yellow before doing a full cycle. But before getting to the lower numbers each time I've seen a sudden bounce down and up again - so started to worry that I might be overdosing rather than under. I only tested and found the low number as a result of seeing unusual behaviour. I will try testing around 2-4pm but work makes it tricky to do this on a regular basis. Can also try for 10:30 before bed.
 
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